Jan 12, 2021
Alyssa G. Rieber, MD, is starting a new job as a private practitioner providing general hematology/oncology care for a rural area in the Hill Country in Texas. Before transitioning to private practice, Dr. Rieber served as the department chair of general oncology and program director of hematology/oncology fellowship at The University of Texas MD Anderson Cancer Center, and as center medical director of the MD Anderson Oncology Program at Lyndon B. Johnson Hospital.
What precipitated your change from academia to private practice?
AR: I have spent the last 9 years of my academic career with increased administrative roles. While they are fulfilling in a certain way, such as when making changes improves care for patients or education for fellows, they have taken me away from patient care and spending time with my family. I have made decisions to increase obligations with the consequences of decreased time with family. Additionally, the opportunity came up to work in a location that I love. I will have more time with my extended family, husband, and children, while working in a beautiful location taking care of patients. It is the perfect opportunity to refocus on what is important. I think this pandemic has definitely narrowed our scope of important things in life. Patient care and family are my driving factors.
For the majority of my career, I have been able to care for the underserved and under/uninsured patients of Harris County, TX. Each patient encounter has been fulfilling and reminded me of the nobility of the work. There was one patient that I vividly recall who told me about his life as a renowned trumpet player traveling the world with the best musicians. He lost all his money and insurance after coming home to care for his mother. It reminded me that every person has worth and a story. We can judge them by their current situations, but we would be missing out on the fullness of their life. I’ve been more committed to getting to know patients and their stories, not just talking about their disease. It helps us all remember that they are more than their diagnosis.
How did you initially choose your career path and what led you to where you are now?
AR: The field of hematology/oncology was chosen for me during medical school. I was diagnosed with Hodgkin lymphoma during my first year of medical school. As the first person in my family with cancer, it definitely wasn’t on my radar. However, my experience as a patient led me to know that God placed this in my life for me to impact others. I chose to train in Houston to be with my husband and was fortunate to train at Baylor College of Medicine and MD Anderson Cancer Center. I was then fortunate to stay on as faculty at MD Anderson. I took advantage of opportunities along the way, leading me to an academic career. I had initially wanted a small-town private practice, but that did not work out for my husband’s job. It does now, so we are moving—20 years later than I initially planned.
Describe your typical work day.
AR: In my academic roles, I have meetings (department, fellowship, institutional) starting at 7 AM and lasting until 6 PM on administrative days. On clinic days (3 days a week), I have 7 AM meetings followed by seeing 15 to 18 patients in clinic—typically, two new patients/consults and 13 to 15 follow-up patients.
If you have to pick one aspect, what part of your job is your favorite? What part is the most challenging or frustrating?
AR: My favorite part of the job is connecting with patients. It is my utmost privilege to be able to provide oncology care to patients in any setting. They are incredibly vulnerable and I am honored to support them, provide information and guidance, and relieve suffering.
The most challenging part of my job is when I know changes should be made to benefit either the patients or providers and my suggestions are ignored. I think that’s a pretty universal frustration for all jobs!
What do you wish you had known before you chose your career path?
AR: I wish I had been better regarding boundaries to ensure I didn’t agree to take on more than I should. I admire people who are able to have clear career goals and don’t agree to things outside of their lane. They typically are well-balanced and not eternally stressed. Unfortunately, I have not been good at making career goals, saying no, or offloading responsibilities to others. These personality traits have led me to situations of having more things on my plate than I should. I have tricked myself into believing I can do it all, but I really can’t long term.
I think others should learn from my experiences. When you add more to your plate, look for something to take off and advocate strongly for it. Many times, that will actually give others an opportunity for leadership and career advancement. Try to think of the most important things to you and make sure you have time for that first: faith, family, hobbies, exercise, a certain research area. Our jobs will always expand to any time you are willing to give them, especially when patient care, leadership positions, or research opportunities are involved. We are all driven to be exceptional and have worked hard to be where we are. We can always do more and do it better. Unfortunately, that drive can be very detrimental to our personal well-being. It’s hard to accept our own perceived mediocrity, but I had to get to that place. That doesn’t mean we should be lazy and do a bad job, it just means that sometimes you can’t be as awesome as you want to be in order to have a more fulfilling life. At the end of the day, we have to make decisions about what is important and make that a priority. It seems so straightforward, but it sure is hard to do.
Why would you recommend this career to someone starting out in oncology?
AR: An academic career is rewarding regarding education of trainees and providing cutting-edge research to move the treatment frontier forward. I recommend it for folks who are not fully committed to seeing patients only.
What kind of person thrives in this professional environment?
AR: Self-starters who get along well with others thrive in any environment. You just need to be willing to do the hard work and do it with humility.